During an ongoing audit of Customs and Border Protection’s (CBP) storage of seized drugs at permanent drug vaults, the Office of the Inspector General (OIG) determined that CBP does not adequately protect its staff from the dangers of powerful synthetic opioids such as fentanyl.
The amount of fentanyl seized by agents and stored in vaults has leapt from 70 pounds in 2015 to 3,500 pounds so far this year. Such quantities put staff at risk, considering a single two milligram dose is lethal for most people, slowing and eventually stopping their breathing.
There are medications designed to treat narcotic overdose in case of accidental exposure, but the OIG audit found that CBP has not always made these available. Naloxone can be injected in the muscle, vein, or skin or sprayed into the nose to restore breathing within two to five minutes and thereby prevent brain injury and death. The medication only works if a person has opioids in his or her system; it has no effect if opioids are absent. As such, naloxone has no potential for abuse.
During the audit, OIG visited seven vaults that contained fentanyl. Two of the vaults did not have naloxone, and an officer at one of the vaults had never heard of it. The other five vaults contained naloxone, but two of the five had it locked in boxes with codes. Of these two, staff had taped a piece of paper bearing the code next to the lock-box at one of the vaults. However, when asked to open the lock-box at the other vault, staff could not open it because they could not remember the code. If this had been an actual event of fentanyl exposure, the staff could have died because they did not have timely access to the naloxone.
With the recent rise in fentanyl seizures, CBP staff now routinely handle fentanyl more than ever. Without easy access to naloxone in case of exposure, their health and lives are at risk.
OIG said the confusion around Naloxone exists because CBP lacks an official policy requiring standard workplace practices for handling fentanyl and safeguarding personnel against exposure. Furthermore, CBP does not require mandatory training for its staff to provide an understanding of the hazards of fentanyl and methods to combat accidental exposure.
Consequently, OIG recommends that CBP revises its Seized Asset Management and Enforcement Procedures Handbook (which was last updated in 2011) to include guidance for handling and storing opioids such as fentanyl. The revision should include a requirement that naloxone be available to all employees, at facilities, and in vehicles involved in seizure, transportation, and storage of fentanyl; and that training be given on administering naloxone.
Following the audit visits, CBP issued a memorandum entitled: “Naloxone Distribution and Training for Seizure Vault Personnel.” The memorandum directed that all permanent vaults be equipped with Naloxone nasal spray kits and lock boxes, and that staff be trained on proper use of the Naloxone spray, an understanding of the hazards of fentanyl, and methods to combat accidental exposure. The estimated completion date is September 30, 2019 and CBP says it has already trained more than 4,500 officers in how to recognize the signs of an overdose since June. It has also deployed 3,300 Naloxone kits in the field and outfitted its storage vaults with safety equipment such as gloves, masks and Tyvek suits.